Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1988 Jan;51(1):94–104. doi: 10.1136/jnnp.51.1.94

Prefrontal cortical blood flow and cognitive function in Huntington's disease.

D R Weinberger 1, K F Berman 1, M Iadarola 1, N Driesen 1, R F Zec 1
PMCID: PMC1032719  PMID: 2965218

Abstract

To examine the relationship between cortical physiology and dementia in Huntington's disease, rCBF during three different behavioural conditions, one of which emphasised prefrontal cognition, was determined by xenon-133 inhalation in 14 patients with Huntington's disease and in matched controls. Cortical rCBF was not reduced in Huntington's disease patients even while they manifested overt prefrontal-type cognitive deficits. Caudate atrophy on CT and rCBF were significantly correlated, but only during the prefrontal behaviour where the correlation was positive. These results suggest a qualification of the subcortical dementia concept as applied to Huntington's disease and implicate an interaction between pathology that is subcortical and cognitive function that is cortical.

Full text

PDF
103

Images in this article

96Image
on p.96
97Image
on p.97
98Image
on p.98
99Image
on p.99

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albert M. L., Feldman R. G., Willis A. L. The 'subcortical dementia' of progressive supranuclear palsy. J Neurol Neurosurg Psychiatry. 1974 Feb;37(2):121–130. doi: 10.1136/jnnp.37.2.121. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Barr A. N., Heinze W. J., Dobben G. D., Valvassori G. E., Sugar O. Bicaudate index in computerized tomography of Huntington disease and cerebral atrophy. Neurology. 1978 Nov;28(11):1196–1200. doi: 10.1212/wnl.28.11.1196. [DOI] [PubMed] [Google Scholar]
  3. Berman K. F., Zec R. F., Weinberger D. R. Physiologic dysfunction of dorsolateral prefrontal cortex in schizophrenia. II. Role of neuroleptic treatment, attention, and mental effort. Arch Gen Psychiatry. 1986 Feb;43(2):126–135. doi: 10.1001/archpsyc.1986.01800020032005. [DOI] [PubMed] [Google Scholar]
  4. Butters N., Sax D., Montgomery K., Tarlow S. Comparison of the neuropsychological deficits associated with early and advanced Huntington's disease. Arch Neurol. 1978 Sep;35(9):585–589. doi: 10.1001/archneur.1978.00500330033006. [DOI] [PubMed] [Google Scholar]
  5. Bès A., Güell A., Fabre N., Dupui P., Victor G., Géraud G. Cerebral blood flow studied by Xenon-133 inhalation technique in parkinsonism: loss of hyperfrontal pattern. J Cereb Blood Flow Metab. 1983 Mar;3(1):33–37. doi: 10.1038/jcbfm.1983.3. [DOI] [PubMed] [Google Scholar]
  6. CHANDLER J. H., REED T. E., DEJONG R. N. Huntington's chorea in Michigan. III. Clinical observations. Neurology. 1960 Feb;10:148–153. doi: 10.1212/wnl.10.2.148. [DOI] [PubMed] [Google Scholar]
  7. Caine E. D., Bamford K. A., Schiffer R. B., Shoulson I., Levy S. A controlled neuropsychological comparison of Huntington's disease and multiple sclerosis. Arch Neurol. 1986 Mar;43(3):249–254. doi: 10.1001/archneur.1986.00520030039009. [DOI] [PubMed] [Google Scholar]
  8. Caine E. D., Hunt R. D., Weingartner H., Ebert M. H. Huntington's dementia. Clinical and neuropsychological features. Arch Gen Psychiatry. 1978 Mar;35(3):377–384. doi: 10.1001/archpsyc.1978.01770270127013. [DOI] [PubMed] [Google Scholar]
  9. Coppola R., Buchsbaum M. S., Rigal F. Computer generation of surface distribution maps of measures of brain activity. Comput Biol Med. 1982;12(3):191–199. doi: 10.1016/0010-4825(82)90001-4. [DOI] [PubMed] [Google Scholar]
  10. Cummings J. L., Benson D. F. Subcortical dementia. Review of an emerging concept. Arch Neurol. 1984 Aug;41(8):874–879. doi: 10.1001/archneur.1984.04050190080019. [DOI] [PubMed] [Google Scholar]
  11. D'Antona R., Baron J. C., Samson Y., Serdaru M., Viader F., Agid Y., Cambier J. Subcortical dementia. Frontal cortex hypometabolism detected by positron tomography in patients with progressive supranuclear palsy. Brain. 1985 Sep;108(Pt 3):785–799. doi: 10.1093/brain/108.3.785. [DOI] [PubMed] [Google Scholar]
  12. Davis S. M., Ackerman R. H., Correia J. A., Alpert N. M., Chang J., Buonanno F., Kelley R. E., Rosner B., Taveras J. M. Cerebral blood flow and cerebrovascular CO2 reactivity in stroke-age normal controls. Neurology. 1983 Apr;33(4):391–399. doi: 10.1212/wnl.33.4.391. [DOI] [PubMed] [Google Scholar]
  13. Fisher J. M., Kennedy J. L., Caine E. D., Shoulson I. Dementia in Huntington disease: a cross-sectional analysis of intellectual decline. Adv Neurol. 1983;38:229–238. [PubMed] [Google Scholar]
  14. Foster N. L., Chase T. N., Mansi L., Brooks R., Fedio P., Patronas N. J., Di Chiro G. Cortical abnormalities in Alzheimer's disease. Ann Neurol. 1984 Dec;16(6):649–654. doi: 10.1002/ana.410160605. [DOI] [PubMed] [Google Scholar]
  15. Frackowiak R. S., Pozzilli C., Legg N. J., Du Boulay G. H., Marshall J., Lenzi G. L., Jones T. Regional cerebral oxygen supply and utilization in dementia. A clinical and physiological study with oxygen-15 and positron tomography. Brain. 1981 Dec;104(Pt 4):753–778. doi: 10.1093/brain/104.4.753. [DOI] [PubMed] [Google Scholar]
  16. Friedland R. P., Budinger T. F., Ganz E., Yano Y., Mathis C. A., Koss B., Ober B. A., Huesman R. H., Derenzo S. E. Regional cerebral metabolic alterations in dementia of the Alzheimer type: positron emission tomography with [18F]fluorodeoxyglucose. J Comput Assist Tomogr. 1983 Aug;7(4):590–598. doi: 10.1097/00004728-198308000-00003. [DOI] [PubMed] [Google Scholar]
  17. Goldman P. S., Nauta W. J. An intricately patterned prefronto-caudate projection in the rhesus monkey. J Comp Neurol. 1977 Feb 1;72(3):369–386. doi: 10.1002/cne.901710305. [DOI] [PubMed] [Google Scholar]
  18. Gur R. C., Gur R. E., Obrist W. D., Hungerbuhler J. P., Younkin D., Rosen A. D., Skolnick B. E., Reivich M. Sex and handedness differences in cerebral blood flow during rest and cognitive activity. Science. 1982 Aug 13;217(4560):659–661. doi: 10.1126/science.7089587. [DOI] [PubMed] [Google Scholar]
  19. Hayden M. R., Martin W. R., Stoessl A. J., Clark C., Hollenberg S., Adam M. J., Ammann W., Harrop R., Rogers J., Ruth T. Positron emission tomography in the early diagnosis of Huntington's disease. Neurology. 1986 Jul;36(7):888–894. doi: 10.1212/wnl.36.7.888. [DOI] [PubMed] [Google Scholar]
  20. Huber S. J., Paulson G. W. The concept of subcortical dementia. Am J Psychiatry. 1985 Nov;142(11):1312–1317. doi: 10.1176/ajp.142.11.1312. [DOI] [PubMed] [Google Scholar]
  21. Josiassen R. C., Curry L. M., Mancall E. L. Development of neuropsychological deficits in Huntington's disease. Arch Neurol. 1983 Dec;40(13):791–796. doi: 10.1001/archneur.1983.04050120041005. [DOI] [PubMed] [Google Scholar]
  22. Kemp J. M., Powell T. P. The cortico-striate projection in the monkey. Brain. 1970;93(3):525–546. doi: 10.1093/brain/93.3.525. [DOI] [PubMed] [Google Scholar]
  23. Kuhl D. E., Phelps M. E., Markham C. H., Metter E. J., Riege W. H., Winter J. Cerebral metabolism and atrophy in Huntington's disease determined by 18FDG and computed tomographic scan. Ann Neurol. 1982 Nov;12(5):425–434. doi: 10.1002/ana.410120504. [DOI] [PubMed] [Google Scholar]
  24. Maher E. R., Smith E. M., Lees A. J. Cognitive deficits in the Steele-Richardson-Olszewski syndrome (progressive supranuclear palsy). J Neurol Neurosurg Psychiatry. 1985 Dec;48(12):1234–1239. doi: 10.1136/jnnp.48.12.1234. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Maximilian V. A., Prohovnik I., Risberg J. Cerebral hemodynamic response to mental activation in normo- and hypercapnia. Stroke. 1980 Jul-Aug;11(4):342–347. doi: 10.1161/01.str.11.4.342. [DOI] [PubMed] [Google Scholar]
  26. Mayeux R., Stern Y., Rosen J., Benson F. Is "subcortical dementia" a recognizable clinical entity? Ann Neurol. 1983 Sep;14(3):278–283. doi: 10.1002/ana.410140305. [DOI] [PubMed] [Google Scholar]
  27. McHenry L. C., Jr, Merory J., Bass E., Stump D. A., Williams R., Witcofski R., Howard G., Toole J. F. Xenon-133 inhalation method for regional cerebral blood flow measurements: normal values and test-retest results. Stroke. 1978 Jul-Aug;9(4):396–399. doi: 10.1161/01.str.9.4.396. [DOI] [PubMed] [Google Scholar]
  28. Metter E. J., Riege W. H., Kameyama M., Kuhl D. E., Phelps M. E. Cerebral metabolic relationships for selected brain regions in Alzheimer's, Huntington's, and Parkinson's diseases. J Cereb Blood Flow Metab. 1984 Dec;4(4):500–506. doi: 10.1038/jcbfm.1984.74. [DOI] [PubMed] [Google Scholar]
  29. Milner B. Interhemispheric differences in the localization of psychological processes in man. Br Med Bull. 1971 Sep;27(3):272–277. doi: 10.1093/oxfordjournals.bmb.a070866. [DOI] [PubMed] [Google Scholar]
  30. Nemeroff C. B., Youngblood W. W., Manberg P. J., Prange A. J., Jr, Kizer J. S. Regional brain concentrations of neuropeptides in Huntington's chorea and schizophrenia. Science. 1983 Sep 2;221(4614):972–975. doi: 10.1126/science.6136092. [DOI] [PubMed] [Google Scholar]
  31. Obrist W. D., Thompson H. K., Jr, Wang H. S., Wilkinson W. E. Regional cerebral blood flow estimated by 133-xenon inhalation. Stroke. 1975 May-Jun;6(3):245–256. doi: 10.1161/01.str.6.3.245. [DOI] [PubMed] [Google Scholar]
  32. Perlmutter J. S., Raichle M. E. Regional blood flow in hemiparkinsonism. Neurology. 1985 Aug;35(8):1127–1134. doi: 10.1212/wnl.35.8.1127. [DOI] [PubMed] [Google Scholar]
  33. Pillon B., Dubois B., Lhermitte F., Agid Y. Heterogeneity of cognitive impairment in progressive supranuclear palsy, Parkinson's disease, and Alzheimer's disease. Neurology. 1986 Sep;36(9):1179–1185. doi: 10.1212/wnl.36.9.1179. [DOI] [PubMed] [Google Scholar]
  34. Risberg J., Maximilian A. V., Prohovnik I. Changes of cortical activity patterns during habituation to a reasoning test. A study with the 133Xe inhalation technique for measurement of regional cerebral blood flow. Neuropsychologia. 1977;15(6):793–798. doi: 10.1016/0028-3932(77)90009-4. [DOI] [PubMed] [Google Scholar]
  35. Risberg J. Regional cerebral blood flow measurements by 133Xe-inhalation: methodology and applications in neuropsychology and psychiatry. Brain Lang. 1980 Jan;9(1):9–34. doi: 10.1016/0093-934x(80)90069-3. [DOI] [PubMed] [Google Scholar]
  36. Sax D. S., O'Donnell B., Butters N., Menzer L., Montgomery K., Kayne H. L. Computed tomographic, neurologic, and neuropsychological correlates of Huntington's disease. Int J Neurosci. 1983;18(1-2):21–36. doi: 10.3109/00207458308985874. [DOI] [PubMed] [Google Scholar]
  37. Shoulson I., Fahn S. Huntington disease: clinical care and evaluation. Neurology. 1979 Jan;29(1):1–3. doi: 10.1212/wnl.29.1.1. [DOI] [PubMed] [Google Scholar]
  38. Vonsattel J. P., Myers R. H., Stevens T. J., Ferrante R. J., Bird E. D., Richardson E. P., Jr Neuropathological classification of Huntington's disease. J Neuropathol Exp Neurol. 1985 Nov;44(6):559–577. doi: 10.1097/00005072-198511000-00003. [DOI] [PubMed] [Google Scholar]
  39. Whitehouse P. J. The concept of subcortical and cortical dementia: another look. Ann Neurol. 1986 Jan;19(1):1–6. doi: 10.1002/ana.410190102. [DOI] [PubMed] [Google Scholar]
  40. Wolfson L. I., Leenders K. L., Brown L. L., Jones T. Alterations of regional cerebral blood flow and oxygen metabolism in Parkinson's disease. Neurology. 1985 Oct;35(10):1399–1405. doi: 10.1212/wnl.35.10.1399. [DOI] [PubMed] [Google Scholar]
  41. Yamamoto M., Meyer J. S., Sakai F., Yamaguchi F. Aging and cerebral vasodilator responses to hypercarbia: responses in normal aging and in persons with risk factors for stroke. Arch Neurol. 1980 Aug;37(8):489–496. doi: 10.1001/archneur.1980.00500570037005. [DOI] [PubMed] [Google Scholar]
  42. Young A. B., Penney J. B., Starosta-Rubinstein S., Markel D. S., Berent S., Giordani B., Ehrenkaufer R., Jewett D., Hichwa R. PET scan investigations of Huntington's disease: cerebral metabolic correlates of neurological features and functional decline. Ann Neurol. 1986 Sep;20(3):296–303. doi: 10.1002/ana.410200305. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES